Florida International University Medical Students Take First Steps To Work With Target Residents In Need

By Meena Rupani
Educating patients in health literacy is the primary goal of Florida International University College of Medicine’s NeighborhoodHELP initiative, says Daniel Castellanos, a second-year medical student involved in the program.

Initially scheduled for a summer start, the program was delayed until fall to ensure the continuity of household visits, said Dr. David Brown, the university’s chief of family medicine.

Most students have had their first meeting with their assigned household.

Participating students are assigned a specific household to follow until graduation. As their education progresses, the student teams will continue working with households to refine care plans in collaboration with the patients’ healthcare providers, according to the college.

A team of three will visit each household: a medical student, a social work student and a nursing student.

Mr. Castellanos detailed how his first meeting with his household in Miami Gardens went.

"Our respective household took us in with open arms. We took our time to identify their health issues, and the next step will be finding ways to educate them and in the long term identify the best resources to treat their specific issues," he said.

Students can’t divulge medical specifics about their patients, according to the Insurance Portability and Accountability Act of 1996 administered by the US Department of Health and Human Services.

The rule is meant to strike a balance that permits important uses of information while protecting the privacy of people who seek care or healing.

Student teams visiting households must adhere to the privacy rule or pay a $100 fee for each failure.

Participating households have at least one person suffering from a chronic disease. Those who live in subsidized housing or have issues with self-care management are prime candidates.

The initiative is targeting four major groups: families in Miami Gardens, Opa-locka and an incorporated area of North Miami-Dade County have been assigned 10 medical students each. The fourth group is made up of the area’s elderly Jewish community, mostly Holocaust survivors.

Christine Matthews, another second-year medical student involved in the program, outlined her experience:

"The only conflict with my household is that they do not speak English so finding a translator will be difficult. However, this experience is preparing us for our future in medicine, where we’ll be dealing with various cultures and the majority of our community is Hispanic."

Ms. Matthews’ household is in unincorporated Miami-Dade.

"Although we cannot provide actual medical care to the patients, we are there to bring them tools they can utilize in the future such as nutrition tips," she added. "Most of the patients do have access to medical care. However, their appointments last approximately 15 minutes each. It’s an in-and-out experience for them and the proper education is not provided."

Ms. Matthews’ first meeting lasted two hours and 20 minutes.

By educating these households, the initiative is meant to generate large savings in healthcare costs.

"If we can help the patients maintain their diabetes and prevent them from getting the long-term side effects of a disease, then the program will be a success. For example by helping with their diabetes we are preventing them from having kidney failure in the future," Ms. Matthews said.

"Most patients complain of not having access to resources, such as getting a walker. This is what we will be helping them with."

Alexis Sanchez, a fourth-year nursing student and a part of Mr. Castellanos’s team, hopes the students can be "the liaison between the patient and their doctors."

"Our family was flexible and gave us all the information we would need to help them at our next visit. They don’t have to trust us considering we are just students," she added.

"With this program, we want to solve a lot of the health disparities present in our community. Most of the patients come from low-income families where their access to education is limited. They only know how to treat their illness in the short term," Ms. Sanchez added.

NeighborhoodHELP is the primary reason most medical students were attracted to the FIU College of Medicine, according to Ms. Matthews.

"Medical school is very technical. We hear lecture upon lecture and we begin to think of medicine through a clinical standpoint," Mr. Castellanos said.

"We learn about the ins and outs of the system, how to identify an issue and how to treat it. We lose sight of the fact that we are not just treating an organ but a human being. Neighborhood HELP will help remind us of that very notion."